According to the NAIC, which insurance coverage is considered primary when both employment-based and dependent coverage exist?

The correct answer is employment-based coverage because, according to the National Association of Insurance Commissioners (NAIC) guidelines, when both employment-based (or group) coverage and dependent coverage are available, employment-based coverage is considered the primary source of insurance. This means that the benefits under the employment-based plan will be utilized first to cover medical expenses before any dependent coverage kicks in.

This principle is based on the premise that employer-sponsored coverage is intended to serve as the main source of health insurance for employees, thereby prioritizing it over other forms of coverage. In many cases, this aligns with the broader framework of coordination of benefits, where primary coverage pays first and the secondary coverage pays any remaining amounts, if applicable.

In scenarios with multiple insurance coverages, it helps determine which insurer has the financial responsibility to pay claims first, thereby streamlining the reimbursement process and reducing complications for healthcare providers and insured individuals alike.